What causes heart palpitations?

Question: Sometimes my heartbeat seems a little off, almost like there’s an extra beat or two. What could be causing these random extra beats and should I be worried?

Answer: “Normal” heart rhythm varies from one person to the next. Heart palpitations are essentially abnormal heart rhythms that may be associated with exercise or anxiety, but may even occur when at rest. Sometimes palpitations are merely a few extra heartbeats, which is actually rather common and generally not of great concern. However, palpitations that feel like multiple erratic heartbeats may signal a more serious heart issue.

Heart palpitations can be caused by abnormalities in structure or function of the heart. This may be the result of damage to the heart such as damage resulting from a prior heart attack or, more rarely, something a person is born with. They can also be caused by lifestyle factors including the use of stimulants like caffeine, nicotine and inhalers. Whatever the cause, it’s important to identify the reason and determine what, if any, treatment is needed.

First, a physician will evaluate a patient’s health history noting any previous heart conditions or known structural deficits. From there, an electrocardiogram (EKG) is performed to identify signs of any obvious electrical problems. This is typically followed by an echocardiogram, which is essentially an ultrasound of the heart that provides a visual reference of its shape, size, valves and any unusual defects a person may have been born with.

If tests show cause for concern but fail to indicate a reason for the palpitations, additional non-invasive tests may be performed. These tests can range from checking electrolytes to ensure normal potassium and magnesium levels, to wearing one of several different heart monitoring devices that may pinpoint symptoms that correlate to the palpitations.

Ultimately, heart palpitations can be a sign of an underlying and potentially life threatening condition. Conversely, they can also be a slight irregularity that doesn’t pose any foreseeable health risk. Either way, it’s best to consult a physician. If it’s concluded that your palpitations are not accompanied by any identifiable health risks, then at least you got peace of mind. But, if tests conclude that your condition warrants treatment, then you’re in a position to explore care options before you find yourself in a dangerous situation.